Case-control Survey Design In Health Research

Case-Control Survey Design

Case-control research or case-control is an analytical study (survey) that concerns how risk factors are studied using a retrospective approach. In other words, an effect (disease or health status) is identified at the present time, then a risk factor is identified as existing or occurring in the past. 

The stages of this case-control research are as follows:

  1. Identification of research variables (risk factors and effects).
  2. Establish the subject of research (population and sample).
  3. Identify the case.
  4. Subject selection as a control.
  5. Perform retrospective measurements (looking back) to see Risk Factors.
  6. Perform analysis by comparing the proportion between the variables of the object of study with the control variables. 

Simple example: researchers want to prove the relationship between malnutrition (malnutrition) in children under five with feeding behavior by the mother.

First step: 

identifying dependent variables (effects) and independent variables (risk factors): dependent variables: malnourished children (cases). Independent variable: maternal behavior in giving food. Other independent variables: mother's education, family income, number of children, and so on.

The second stage: 

Establish the subject of the study, that is, the population and sample of the study. The subjects of the study here were a couple of mothers and their toddlers. Nevertheless, it is necessary to limit the pairs of mothers and toddlers in which areas are considered to be the population and sample of this study.

The third stage: 

Identifying cases, namely children under five who suffer from malnutrition. What is meant here is the case of children under five who meet the criteria of malnutrition that have been set for example the weight per age is less than 75% of the Harvard standard. Cases are taken from a predefined population.

The fourth stage: 

The selection of subjects as controls, IE pairs of mothers with their toddlers who do not suffer from malnutrition. Control selection should be based on the similarity of the characteristics of the subject in the case. 

For example, the characteristics of society, social economy, geographical location, and so on. In fact, it is difficult to select a control group that has the same characteristics as the case Group. Therefore, most of these characteristics can be considered representative.

The fifth stage: 

Perform measurements retrospectively, ie from the case (children under five who are malnourished) and from the control (children who are not malnourished) was measured or asked the mother using the recall method of behavior or habits of giving food to her child. Recall here means asking the mother of children under five cases about the types of food and the amount given to children under five during a certain period. Usually use the 24-hour method (24 hours recall).

The sixth stage: 

Perform data processing and analysis. Data analysis was conducted by comparing the proportion of good and poor maternal behavior in terms of giving food to their children in the case Group, with the same proportion of maternal behavior in the control group. From this, evidence will be obtained of the presence or absence of a relationship between feeding behavior and malnutrition in children under five.

Advantages Of Case Control Research Design

  1. There is a similar measure of time between the case Group with the control group.
  2. The existence of restrictions or control of risk factors so that the results of the study more sharply than the results of cross-sectional design.
  3. Not face ethical constraints as in experimental or cohort research.
  4. Does not require a long time (more economical).
  5. Disadvantages Of Case Control Research Design
  6. Measurement of variables that are retrospective, objectivity, and reliability are lacking because the study subjects must recall the risk factors.
  7. It cannot be known the effect of outside variables because they are technically uncontrollable.
  8. Sometimes it is difficult to choose a control that really fits the case group because of the many risk factors that must be controlled.


Notoatmodjo, S. (2010). Notoatmodjo s Health Research Methodology, editor. Jakarta: PT. Rineka Cipta.

Creswell, J.W., & Miller, D. (2000). Determining validity in qualita¬tive inquiry. Theory into Practice, 39(3), 124-130.

Bowling, A. (2014). Research methods in health: investigating health and health services. McGraw-hill Education (UK).

Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approach. Sage publications.

Creswell, J.W. & Piano Clark, V.L. (2007). Designing and Conducting Mixed Methods Research. Thousand Oaks, CA: Sage.

Green, J., & Thorogood, N. (2018). Qualitative methods for health research. sage.

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